Document Detail


Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: age and gender rather than severity matters.
MedLine Citation:
PMID:  20714380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dry powder inhalers (DPIs) are inspiratory flow driven and hence flow dependent. Most patients with chronic obstructive pulmonary disease (COPD) are elderly and have poor lung function. The factors affecting their inspiratory flows through inhalers are unclear.
OBJECTIVE: To study peak inspiratory flows (PIFs) and their determinants through a DPI in COPD patients of varying age and severity.
METHODS: Flow-volume spirometry was performed in 93 COPD patients. Maximum PIF rates were recorded through an empty Easyhaler (PIF(EH); Orion Corporation, Espoo, Finland), a DPI that provides consistent dose delivery at inhalation rates through the inhaler of 28 L/min or higher.
RESULTS: The mean PIF(EH) was 54 L/min (range 26-95 L/min) with a coefficient of variation of 7%. All but two patients were able to generate a flow of > or = 28 L/min. In a general linear model, the independent determinants for PIF(EH) were age (P = 0.02) and gender (P = 0.01), and forced expiratory volume in 1 s (FEV(1)) expressed as percent predicted was not a significant factor. The regression model accounted only for 18% of the variation in PIF(EH).
CONCLUSION: In patients with COPD, age and gender are more important determinants of inspiratory flow through DPIs than the degree of expiratory airway obstruction. Most COPD patients with varying age and severity are able to generate inspiratory flows through the test inhaler that is sufficient for optimal drug delivery to the lower airways.
Authors:
L Pekka Malmberg; Paula Rytilä; Pertti Happonen; Tari Haahtela
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-09
Journal Detail:
Title:  International journal of chronic obstructive pulmonary disease     Volume:  5     ISSN:  1178-2005     ISO Abbreviation:  Int J Chron Obstruct Pulmon Dis     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-17     Completed Date:  2010-12-03     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101273481     Medline TA:  Int J Chron Obstruct Pulmon Dis     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  257-62     Citation Subset:  IM    
Affiliation:
Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland. pekka.malmberg@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Aged
Aged, 80 and over
Drug Delivery Systems
Female
Finland
Forced Expiratory Volume
Humans
Male
Middle Aged
Nebulizers and Vaporizers*
Outcome Assessment (Health Care) / methods
Powders / therapeutic use*
Pulmonary Disease, Chronic Obstructive / drug therapy*
Respiratory Function Tests
Severity of Illness Index
Spirometry / methods
Chemical
Reg. No./Substance:
0/Powders
Comments/Corrections

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